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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Focus Groups of US Adults KAP of Foodborne Disease Outbreaks and Illness Prevention
Agency IC Tracking Number:
0920-1154-19ACH
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
none
Recruitment Screener
Attachment C Recruitment Phone Script for CDC 3.14.19.docx
Yes
Yes
Fillable Fileable
Form and Instruction
none
Recruitment Follow-up Contact
Attachment B CDC Foodborne recruitment communication 3.14.19.docx
Yes
Yes
Fillable Fileable
Other-Moderator Guide
Attachment E CDC Foodborne Outbreak Draft Knowledge and Practices Protoc 3.14.19.docx
Yes
No
Paper Only
Other-Moderator Guide with Interview
Attachment F CDC Foodborne Message Test Guide 3.14.19.docx
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
804
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
93 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
804
0
804
0
0
0
Annual IC Time Burden (Hours)
157
0
157
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement A
Supporting Statement A (0920-1154).docx
03/14/2019
Supporting Statement B
Supporting Statement B (0920-1154).docx
03/14/2019
Sampling Plan
Attachment A Sampling Plan12.18.18.docx
03/14/2019
Consent
Attachment D Consent Forms12.18.18.docx
03/14/2019
Messages to Test
Attachment G Messages to Test 1.28.18.docx
03/14/2019
Nonresearch Determination
Attachment H Non-research Determination.pdf
03/14/2019
Request for Approval
GenIC Request Template.docx
03/14/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.